Padilla-Rodríguez G, Gómez-González A, Barquero-Alemán M, Méndez-Santos I, García-Rubira J C
Cardiology Unit, Virgen Macarena Hospital, Avd. Dr. Fedriani 3, 41009 Seville, Spain.
Cardiovascular Surgery, Virgen Macarena Hospital, Avd. Dr. Fedriani 3, 41009 Seville, Spain.
Eur Heart J Case Rep. 2025 May 22;9(6):ytaf250. doi: 10.1093/ehjcr/ytaf250. eCollection 2025 Jun.
Ascending aortic dissection rarely presents as acute myocardial infarction, and when it does, its diagnosis is even more challenging.
We present a case of a young male with corrected congenital heart disease and a giant ascending aorta aneurysm. He was admitted to hospital for chest pain and was diagnosed with acute anterior myocardial infarction. Imaging tests showed dissection of the ascending aorta. He required complex cardiovascular surgery for Dacron tube implantation to treat the giant ascending aortic aneurysm.
This case is a reminder of how important adequate differential diagnosis is in the context of myocardial infarction, as well as the management of acute aortic syndrome. In our patient, the patency of the left coronary artery was verified using imaging techniques, and the most likely cause of the infarction could be the aneurysm extrinsically compressing the coronary artery.
升主动脉夹层很少表现为急性心肌梗死，一旦出现，其诊断更具挑战性。
我们报告一例患有先天性心脏病矫正型和巨大升主动脉瘤的年轻男性病例。他因胸痛入院，被诊断为急性前壁心肌梗死。影像学检查显示升主动脉夹层。他需要进行复杂的心血管手术，植入涤纶管以治疗巨大升主动脉瘤。
该病例提醒我们，在心肌梗死的背景下，充分的鉴别诊断以及急性主动脉综合征的管理是多么重要。在我们的患者中，使用影像学技术证实了左冠状动脉的通畅，梗死最可能的原因可能是动脉瘤对冠状动脉的外在压迫。
